In many cases for a patient to effectively take medicine in tablet or pill form, it is necessary to crush medicine so formed. Throughout this application, pill and tablet may be used interchangeably. The crushed pill is then dispersed in a food carrier and fed to the patient--thereby delivering the medicine to the patient.
Such pill crushing is necessary for infants. It has also become necessary for some groups of elderly people. This is especially true of people confined to nursing homes. Some people confined to nursing homes have lost the physical skills necessary for swallowing a pill. It thus becomes necessary to crush the pill or tablet, mix the crushed pill or tablet with a food such as applesauce or similar food and spoon feed the medicine to the patient.
Commonly, a pill is either in a prepackaged envelope as a container or put in a paper cup as a container. The crushing device must be able to crush the pill without ripping the container. If the container is not ripped as the pill is crushed, the crushed pill can effectively be mixed with a food stuff. The mixture may then be fed to the patient. Thus, the pill may be taken with greatly minimized loss of the medication.
Many devices are known in the art for crushing pills. All of the known devices have caused great difficulty for the nursing staff or other users thereof. The known devices for crushing a pill or a tablet are so inefficient, that it is known to use a substitute, such as crushing a pill in a door jamb or pounding the pill. Yet, the pill must be crushed efficiently and removed from the pill container efficiently. The pill must also then be dispersible in food efficiently.
It is common for a patient in a nursing home to take a large plurality of pills. The time it takes to crush and dispense these pills into a food occupies a great portion of scarce nursing time. An efficient device for crushing the pills can be of great assistance to the nurse delivering the medicine.
In the State of Illinois alone, there are over one thousand nursing homes--including, but not limited to, homes for the developmentally disable, and mentally retarded and mentally ill. Then there are both skilled and intermediate care homes for the aged. It is safe to assume that the average facility has at least one hundred beds. Thus, there are approximately 100,000 beds in the State of Illinois devoted to long term care.
From a statistical standpoint, approximately thirty (30%) percent of these people so confined cannot swallow medications in the form of tablets or pills. When the prescribed medication comes only in the form of a tablet or pill and not in liquid form, the patient must therefore have each medication crushed into powder form.
By a study of forty facilities, it is known that the average patient takes six medications at least twice daily. This means that the average patient requires that twelve pills be crushed each day. In turn, the result becomes over 360,000 pills are being crushed daily in the State of Illinois alone.
It follows that the amount of time this pill crushing is taking nationwide must be incredible. The most efficient, safe and yet fast tool to do this job of pill or tablet crushing is necessary so that every minute saved can be spent with the patients in doing other necessary procedures. This pill crushing, while time-consuming and time-wasteful, is important enough to require a nurse. Such a wasteful use of nursing time greatly aggravates to the nursing shortage in this country, which is already in critical shape. One need only survey a hospital or a nursing facility to confirm this shortage. The nurse needs to have a safe, speedy and efficient tool with which to crush the medications of the patients, either in hospitals or nursing facilities, that are assigned her care.
Typical of the pill crusher of the prior art are serrated cylindrical devices. These devices have rough edges which either tear the package in which the pill is contained or retain a portion of the pill within the rough crushing area. The tearing of the package has a number of undesirable effects--including, but not limited to, loss of the medicine. The residual medicine in the rough area is a contaminant, which renders the crusher unsuitable for use with other medicines.
Other crushing devices provide for an inconvenient way of holding the pill as it is being crushed. Still other pounding devices crush the pill inefficiently and the noise created by pounding is disturbing to the patients. Thus, it is desirable to find an efficient crushing device for pills. If this can be accomplished, great advantages are obtained.
The need, then, for the patient is:
1) to have his or her medications crushed if they are unable to swallow them whole, and if they do not come in a liquid form; PA1 2) to have these medications crushed so that they are pulverized finely enough and put into a soft food substance so that they can be swallowed without danger of choking; PA1 3) to have these medications crushed in a quiet, undisturbing manner (many methods require pounding or hammering on the pills which is done on the medicine cart near the patient); and PA1 4) to have the above named process of pill-crushing done as rapidly as possible, so that the nurse can be available for other bedside care.
Noise caused by pounding to pulverize the pills and other noise of this nature confuse the elderly and already confused patients, and cause them to wonder where the knocking is coming from. At night, this noise can actually cause disrupted sleep. For residents with Alzheimer's Disease and other related dementias, it is of utmost importance to keep a quiet atmosphere.
One type of currently available pill-crusher is a personal, screw-type device made of a plastic. This device cannot be used with unit dose packaging that is common to institutions such as nursing homes or hospitals. Another problem is that this device becomes grossly contaminated with medication particles without cleaning between each patient use. This cleaning is far too time consuming. Furthermore, just screwing a top down onto the bottom portion where pills are placed does not always crush the pill with ease--especially those pills with a hard coating. Additionally, this plastic is not durable enough for constant, institutional use. A crusher can be used recommended for home use for one patient.
Crushers with handles for compressing and crushing pills in a medicine cup generally come in either a plastic or a stainless steel version. These devices cannot be used to crush a pill or tablet while it is still in a unit dose package, thus causing another time consuming step (taking pills out and placing them in a medicine cup, then placing the cup into the crusher). These handle-operated crushers tend to "flatten" pills instead of pulverizing them. Sometimes it takes many strokes of the handle to break up pills. The stainless steel model is heavy, and the plastic version is not durable enough for constant use. Both items take up a lot of space on top of the medicine cart. When some medications that are difficult to crush require repeated thrusts of the handle, that movement causes disturbing noise.
Pounding type devices do not work any better than crushing devices. Typical pounding devices include mortar and pestal, hammer, and other heavy objects. Some receptacles for the pills in these devices are small and therefore, the pills cannot be crushed while still in their unit does package. Pounding is loud and causes much confusion for the residents. Alzheimers or dementia type patients become agitated when they do not understand where the pounding is coming from. Many patients report that it is difficult to sleep when nurses are causing so much noise when crushing pills in the hallway.
Glass mortars can break when firm pounding is required. If pills are taken out of the package and placed into the pill receptacle of the pounding device, cleaning of the device afterwards becomes a major problems, as it is again time consuming.
It becomes clear that a major improvement in a pill crusher can be a distinct advantage for the nurse.